Root Cause Analysis Identifying critical campaign challenges and diagnosing bottlenecks - PowerPoint Presentation

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Root Cause Analysis

Identifying critical campaign challenges and diagnosing bottlenecks

Root Cause Analysis

Agenda

Introduction to Root Cause Analysis (RCA)

Keys steps for conducting root cause analyses Assessing potential impact and actionability of addressing root causes

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Introduction to

Root Cause Analysis

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What is Root Cause Analysis?

A problem-solving method to identify underlying causes of key process challenges

A tool for learning from observed bottlenecks and mitigating them in the future & learning from successes and promoting best practices

A learning process to determine what happened, why it happened, and what should be done to improve it

An iterative approach – both hypothesis generating and confirming

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Why?

Why?

Why?

Learning objectives

By the end of this module, users should be able to:

Understand and describe a common approach to identifying challenges or bottlenecks that may be limiting to the effectiveness of a campaign.

Perform a root cause analysis to determine what’s causing the challenge or bottleneck.

Assess and prioritize root cause(s) that are actionable.

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Root Cause Analysis

Key Steps

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Overview of the key RCA steps

Step 1:

Identify issues or bottlenecks

Step 2:

Define the key problem or challenge (or success)

Step 3: Chart the RCA diagram

Step 4:

Validate the RCA through iterative and participatory processes

Step 5:

Identify the most impactful and actionable root causes

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STEP 01

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Identify campaign issues or bottlenecks

Brainstorm observed challenges, issues, or bottlenecks

Draw on multiple sources of data:

Routine and non-routine sources

Observations from supervision visits

Document review

Ke

y informant interviews and/or focus groups

Categorize identified challenges into domains to help recognize where challenges are concentrated

Planning

Funding

Human resources

Disease/epidemiological context

Logistics management

Data/monitoring and evaluation

Leadership, management, and coordination

Intervention characteristics/design

Population and patient characteristics

Advocac

y and social mobilization

Contextual factors

Social determinants

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STEP 02

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Define the key problem or challenge (or success)

Tips and Considerations

Use plain language to ensure clear articulation and understanding of the challenge (or success) by the evaluation team and other relevant stakeholders

If multiple challenge statements are identified, some will likely fall along the causal pathway between root cause and overall challenge

Where there are multiple challenges, consider which are most actionable to address

Although challenges are most often the focus of RCA, examining successes as well can facilitate learning and sharing of best practices

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Examine your list of challenges – which one is most closely related to the desired outcome or impact?

For example:

If measles outbreaks continue to occur after a measles campaign...

Potential challenge statement: Measles outbreaks continue to occur

If campaign coverage is lower than expected...

Potential challenge statement: Low coverage

STEP 03

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Chart the RCA diagram

Tips and Considerations

Work backwards from the prioritized challenge through assumed causal factors to arrive at most

likely root cause

RCA often performed as a group exercise; drawing on diverse perspectives strengthens the RCA

Charting the RCA helps identify evidence gaps and where additional validation is needed

Put everything down on paper first, then investigate and iterate further. Messy is okay!

Transfer draft RCA to PowerPoint for sharing digitally; use for further iteration and development

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RCA usually involves a visual schematic to document assumed causal chains; flow charts work well

Probes such as ‘Who, What, Where, When, and How’ questions help in assessing challenges

Who

were the stakeholders involved?

What

information was available to key stakeholders?

Where

did the challenge or problem happen?

How

widespread is the challenge or problem? How well were procedures carried out?

‘5 Whys’ technique for getting at the root cause

EXAMPLE RCA:

Human African Trypanosomiasis Elimination Initiative

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STEP 04

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Validate the RCA through iterative and participatory processes

Tips and Considerations

Are there other types of data that need to be collected? Identify gaps and make plans for additional data collection

Consider what contextual and/or environmental factors may be affecting the causal chain

Design choices such as color-coded boxes and solid vs. dotted lines can help conve

y relationships

Developing a draft RCA prior to the stakeholder workshop helps validate the evaluation team’s analyses with stakeholders and uncover additional supporting information

See

Participatory Workshop Design Considerations

in RCA Toolkit for guidance on carrying out the workshop

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RCA benefits from iteration – update and refine your RCA as additional data is collected and analyzed

A participatory process helps confirm assumptions and linkages in the RCA, causal factors, and the key challenges

A participatory workshop is a low-cost, efficient approach to RCA validation

Engage a variety of stakeholders with diverse perspectives, such as: Ministry of Health officials, district health planners, program managers, implementers, technical partners, and donors

Reaching consensus on root cause(s) is critical before moving onto designing solutions/interventions

STEP 05

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Identify most impactful and actionable root causes

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Identifying actionable and impactful root causes is a critical step prior to intervention design

Common considerations for assessing actionability and impact are summarized

Feedback on actionability and impact can also be gathered through a participatory workshop

Use a 2x2 table to organize which root causes are most actionable, and if addressed, likely to drive the most impact

Root causes

Low potential impact

High potential impact

Low actionability

High actionability

Assessing potential impact and actionability of addressing root causes

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Considerations to assess

potential impact and actionability

of addressing root causes

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Determinants of RCA usefulness

Strong engagement with stakeholders

– key actions must be bought into the RCA causal pathway

RCA

strikes the right tone in framing challenges and successes A policy or program window exists

within which changes can be enacted and adopted RCA is accompanied by actionable recommendations to help frame further discussion on intervention design

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Thank you!